Back
Pain, A Historical Review
A few years back Dr. Dana M. Street, M.D., the Emeritus Professor
of Orthopaedic Surgery at Loma Linda University wrote a forward
for one of Dr. Rezaian's books.
We thought that it would be a good start for our "Brief
History" section.
| FOREWORD
I am honored
to write a foreword for what I consider to be one of
the most outstanding advances of this century, in the
treatment of major spine injuries
Early in the
century, we had stabilization of the spine by spine
fusion posteriorly. There was correction of deformity
by
casts in the 1930's, with or without fusion, followed
by decompression posteriorly in the 1940's and fusion
anteriorly in the 1950's. Stabilization and correction
of deformity using various internal devices posteriorly
and laterally have been developed since the 1960's.
Now we have anterior decompression with correction of
deformity and stabilization by replacement of the fractured
vertebral body and fusion.
Because the
spine is more easily approached from posterior, it was
natural for the posterior mechanisms to be used first
and then the lateral. With these the attempt is to correct
the kyphontic angle and restore the space between the
bodies of the adjacent vertebra with a distracting force
on the bodies to draw the crushed fragments back into
position, hopefully including any protruding into the
spinal canal. This anterior approach, on the other hand,
applies a driving force and in the direct line of the
bodies rather than at a distance. A driving force is
more efficient than a traction force. One can often
drive a nail out, which cannot be pulled out.
The mechanism
of this device is simple, a screw jack similar to the
jack used to raise the corner of a house or level a
refrigerator. With it locked in place it provides good
rigidity and chance for interbody fusion. Obviating
the need for a cast or brace is a tremendous plus and,
with little chance of loosening after fusion, the long
term results should be excellent, provided asepsis was
maintained or achieved.
The chance
for decompression under. Direct vision is optimal. The
cases presented show good neurological recovery at cauda
equinal levels, even after considerable length of time.
It is hoped that with prompt decompression recovery
may also result, even at cord levels, at least in the
incomplete or progressive lesions.
I congratulate
and thank the authors for their truly significant contribution.
Dana M. Street,
MD
Emeritus Professor of Orthopaedic Surgery
Lorna Linda University, 1995
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Innovations by California Orthopaedic
Medical Clinic
California Orthopaedic Medical Clinic, Inc. is involved in
ongoing research and development in the field of orthopaedic
surgery. We would be pleased to respond to any inquiries regarding
these techniques, and will provide further information, as
required.
We have developed a number of techniques including:
1 . We have published: A New Clinical Classification For
The Correct Diagnosis of Back Pain. Based on this classification,
we can accurately diagnose the cause of back pain and then
offer the best guideline for the treatment.
2. The Rezaian Spinal Fixator.
This device is approved by the FDA, patented in USA and abroad.
It is a new hope for intractable back pain due to serious
fracture of the spine. Many patients, with incomplete paraplegia,
wheelchair bound, may be able to walk again. It may be used
for the treatment of intractable back pain for patients with
"failed back syndrome".
3. Dr. Rezaian is a pioneer in practicing the latest surgical
techniques including percutaneous discectomy, a simple technique
for the removal of a herniated disc under local anesthesia
using a laser. This technique involves one-day hospitalization
(in and out the same day). It does not involve the traditional
incision associated with herniated disc surgery. Many patients
return to work in 2-6 weeks following surgery.
4. We have perfected a technique for fusion after cervical
(neck) disc surgery. Using this technique, most patients with
a herniated disc will only spend 1-2 days in the hospital.
Most patients will not need a brace or any kind of immobilization.
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